Healthcare Provider Details

I. General information

NPI: 1801317052
Provider Name (Legal Business Name): LISA OKEEFE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 BAYSIDE ROAD
EUREKA CA
95501-0299
US

IV. Provider business mailing address

381 BAYSIDE RD
ARCATA CA
95521-6497
US

V. Phone/Fax

Practice location:
  • Phone: 707-683-2712
  • Fax:
Mailing address:
  • Phone: 707-683-2712
  • Fax: 707-443-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW77234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: